By  Rocky Wilson

Spokane Physiatrist Dr. Karen Stanek says a fast-growing number of people here are using two little-known tools in the fight against a debilitating muscle-contraction problem known as Spasticity.

She says usage of implantable medicine pumps to treat spasticity has doubled in the Spokane-Coeur d’Alene area in the last four years, and the use of Botox injections for the same reason has doubled in the past two years.

The treatments don’t cure severe spasticity, but can relieve its symptoms so that patients can maneuver their own wheelchairs without assistance, feed themselves, or even master enough muscle control to become active in the work force, says Stanek, owner of Northwest Medical Rehabilitation PS.

“Spasticity occurs in many different disease processes,” Stanek says. “An inflammation in the brain or spinal cord can create an imbalance of muscle tightness,” such as muscle spasms for people suffering from a spinal injury or who were born with cerebral palsy.

“I work with patients with disabilities and help them become Functional,” she says.

Stanek is a certified physiatrist, which means she’s a medical doctor who specializes in physical medicine and rehabilitation.

“I prescribe therapy, but I don’t do therapy,” she says, adding that follow-up therapy is “a very important piece” of any patient’s total rehabilitation program.

Stanek says she’s one of few physicians here who prescribe the use of implantable baclofen pumps and injections of Botox, known more widely as a cosmetic surgery drug, to combat the condition.

Baclofen pumps, implanted in a patient’s abdomen, provide a steady flow of medicine through a Catheter that’s inserted into the intrathecal area, a spot underneath a certain membrane around the spinal cord.

Spasticity is characterized by tight, stiff muscles that make movement, especially in the arms or legs, difficult or uncontrollable. Patients diagnosed with spasticity most often have suffered a serious injury to their spinal cord or brain, while others have cerebral palsy, Multiple Sclerosis, or are victims of strokes.

The pumps Stanek prescribes are implanted by surgeons and are known as Intrathecal Baclofen pumps.

The injections of Botox, which is a protein complex, are done either instead of the surgery or in conjunction with it, she says.

Northwest Medical Rehabilitation, which is located at 1315 N. Division and employs 15 people, works with about 220 patients on an ongoing basis who have received a baclofen pump, Botox injections, or both, Stanek says.

She says the use of the implantable pump or combination of the pump and Botox injections is done only in patients with more severe degrees of spasticity, while Botox alone is used for about half of the spasticity patients she sees.

Baclofen pumps, which are round, about the size of a tape measure, made of titanium, and battery operated, were first implanted in patients to combat spasticity in 1988, though modern pumps that could provide a more constant flow of medicine were first commercialized in 2000.

Botox, a purified protein complex derived from bacteria, was used in cosmetic surgery before the U.S. Food and Drug Administration approved it to help control certain types of spasticity as well, in 2000, says Allergan Inc., its Irvine, Calif.-based manufacturer.

Stanek says it’s likely that many more spasticity patients here would benefit from a baclofen pump or Botox treatments if they knew they were available.

“If more people were to use these tools to treat spasticity, it would decrease the overall cost of treatment and significantly improve their quality of life,” she says.

Although most insurance companies cover both treatments today, they are expensive, Stanek says. The cost of implanting a baclofen pump, including the surgery, $10,000 price of the device, and follow-up care, is about $26,000, she says.

The Botox injections can cost as much as $4,200 for a three-month dosage, Stanek says. Patients receive up to four injections in a single muscle, and up to 20 injections at a time if they have spasms in multiple muscles, she says.